PMID- 30768935
OWN - NLM
STAT- Publisher
LR  - 20190407
IS  - 1097-6868 (Electronic)
IS  - 0002-9378 (Linking)
DP  - 2019 Feb 12
TI  - Increased the risk of osteoporosis with hysterectomy: a longitudinal follow-up
      study using a national sample cohort.
LID - S0002-9378(19)30359-X [pii]
LID - 10.1016/j.ajog.2019.02.018 [doi]
AB  - BACKGROUND: Premenopausal hysterectomy is associated with a decreased ovarian
      reserve, follicular atresia, and subsequently reduced long-term estrogen
      secretion. Therefore, women who undergo hysterectomy will experience greater
      gradual bone mineral loss than women with an intact uterus and have an increased 
      risk of osteoporosis. OBJECTIVE: This study aimed to evaluate the association
      between hysterectomy without/with bilateral oophorectomy and the occurrence of
      osteoporosis using a national sample cohort from South Korea. STUDY DESIGN: Using
      the national cohort study from the Korean National Health Insurance Service, we
      extracted data for patients who had undergone hysterectomy (n=9082) and for a 1:4
      matched control group (n=36,328) and then analyzed the occurrence of
      osteoporosis. The patients were matched according to age, sex, income, region of 
      residence, and medical history. A Cox proportional hazards model was used to
      analyze the hazard ratios and 95% confidence intervals. Subgroup analyses were
      performed based on age and bilateral oophorectomy status. The age of the
      participants was defined as the age at the time of hysterectomy. RESULTS: The
      adjusted hazard ratio for osteoporosis was 1.45 (95% confidence interval,
      1.37-1.53, P<.001) in the hysterectomy group. The adjusted hazard ratios for
      osteoporosis in the different age subgroups of this group were 1.84 (95%
      confidence interval, 1.61-2.10) for ages 40-44 years, 1.52 (95% confidence
      interval, 1.39-1.66) for ages 45-49 years, 1.44 (95% confidence interval,
      1.28-1.62) for ages 50-54 years, 1.61 (95% confidence interval, 1.33-1.96, all
      P<.001) for ages 55-59 years, and 1.08 (95% confidence interval, 0.95-1.23,
      P=.223) for ages >/=60 years. The adjusted hazard ratios for osteoporosis
      according to hysterectomy/oophorectomy status were 1.43 (95% confidence interval,
      1.34-1.51) in the hysterectomy without bilateral oophorectomy group and 1.57 (95%
      confidence interval, 1.37-1.79) in the hysterectomy with bilateral oophorectomy
      group. CONCLUSION: The occurrence of osteoporosis was increased in patients who
      had undergone hysterectomy compared with that in matched control subjects
      regardless of bilateral oophorectomy status.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Choi, Hyo Geun
AU  - Choi HG
AD  - Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College 
      of Medicine, Anyang, Republic of Korea; Hallym Data Science Laboratory, Hallym
      University College of Medicine, Anyang, Republic of Korea.
FAU - Jung, Yoon Jung
AU  - Jung YJ
AD  - Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital,
      Hallym University College of Medicine, Anyang, Republic of Korea.
FAU - Lee, Suk Woo
AU  - Lee SW
AD  - Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital,
      Hallym University College of Medicine, Anyang, Republic of Korea. Electronic
      address: ssugucap@naver.com.
LA  - eng
PT  - Journal Article
DEP - 20190212
PL  - United States
TA  - Am J Obstet Gynecol
JT  - American journal of obstetrics and gynecology
JID - 0370476
OTO - NOTNLM
OT  - Korea
OT  - cohort studies
OT  - hysterectomy
OT  - osteoporosis
EDAT- 2019/02/16 06:00
MHDA- 2019/02/16 06:00
CRDT- 2019/02/16 06:00
PHST- 2018/09/13 00:00 [received]
PHST- 2018/12/24 00:00 [revised]
PHST- 2019/02/06 00:00 [accepted]
PHST- 2019/02/16 06:00 [pubmed]
PHST- 2019/02/16 06:00 [medline]
PHST- 2019/02/16 06:00 [entrez]
AID - S0002-9378(19)30359-X [pii]
AID - 10.1016/j.ajog.2019.02.018 [doi]
PST - aheadofprint
SO  - Am J Obstet Gynecol. 2019 Feb 12. pii: S0002-9378(19)30359-X. doi:
      10.1016/j.ajog.2019.02.018.